Bite magazine is a business and current affairs magazine for the dental industry. Content is of interest to dentists, hygienists, assistants, practice managers and anyone with an interest in the dental health industry.
DECEMBER 2012, $5.95 INC. GST PRINT POST APPROVED NO: 255003/07512 SPECIAL REPORT Website and email product guide, page 35 The end of fear Dr Avanti Karve is looking at ways to tackle dental phobia and other problems faced by special needs patients through an holistic model of oral healthcare Easy being green How your dental surgery can balance environmental and infection control responsibilities, page 28 A whiter shade of pale Want to see the cutting- edge in surgery design? It’s on page 22 Red dust dentistry Where do you experience the toughest dental problems you’ll face? Ask the Kimberley Dental Team Muddy waters The dentist tackling the Kokoda challenge
Transcript
december 2012, $5.95 INc. GST
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SPECIAL REPORT
Website and em
ail product
guide, page 35
The end of fear
Dr Avanti Karve is looking at ways to tackle dental phobia
and other problems faced by special needs patients
through an holistic model of oral healthcare
Easy being greenHow your dental surgery
can balance environmental and infection control
responsibilities, page 28
A whiter shade of pale Want to see the cutting-
edge in surgery design? It’s on page 22
Red dust dentistry Where do you experience
the toughest dental problems you’ll face? Ask
the Kimberley Dental Team
Muddy watersThe dentist tackling the
Kokoda challenge
Extreme MeasuresThe difference is in the details.
The A-dec 500 chair is qualified for a 181.44 kg patient. We test to four times the warrantied load. The photograph is a simulated representation of a static load test for an A-dec 500 chair. As part of the actual stress-point evaluation, a combined load of 725.75 kg was spread across upper and lower sections of the chair.
Because your focus is on the patient, every A-dec solution is proven to deliver smooth, trouble-free performance. We test to fail. By evaluating the strength of the A-dec 500 chair, for example, we subjected the chair to four times its guaranteed weight limit. Stress points were analyzed. Functionality scrutinized. A-dec goes to extremes because your investment should never let you down.
Visit a-dec.com/thedifference to find out how every detail behind an A-dec solution adds up to lasting reliability.
COVER STORY YOUR BUSINESS YOUR TOOLS YOUR LIFECONTENTS
03
ContentsNews & eveNts4. Changing of the guardThe Australian Dental Association has a new president; and more
your world10. Fly-in dentistsDr John and Jan Owen have established a fly-in clinic in the Kimberley where dentists can learn how to deal with the some of the worst oral health problems they’re likely to face.
your busiNess 20. On the listIf you’re considering selling your practice, read these expert tips on how to run your practice so it’s ready to go when you are
22. Internal affairsInnovative dental surgery design can act as an extension of brand identity. But it must be true to the ethos of the practice
28. Green daysHow do you balance environmental responsibility with responsibility to your patients? We look at the practices who are thinking globally and acting locally your tools 8. New products
The best new gear and gadgets from suppliers you can trust
33. Tools of the tradeReviews of your favourite products by your peers
35. Website and email product guide Everything you need to know about the website and email products for dentists
your life46. On the trackDespite pouring rain, painful blisters and muddy hills, Dr Tim Topalov of River Dental in Gympie, Queensland, was determined to finish the Kokoda Challenge
2210
3328
Cover storyWhat you needMany dentists would be happy not having to deal with either special needs patients, or those with intense dental phobia. Dr Avanti Karve has made a career out of dealing with both.
December 2012
16
8,163 - CAB Audited as at September, 2012
Editorial Director Rob Johnson
Sub-editor Kerryn Ramsey
Creative Director Tim Donnellan
Contributors Mary Banfield, Andy Kollmorgen, Susanna Nelson, Amanda Lohan, Sarah Hollingworth
Commercial Director Mark Brown
Bite magazine is published 11 times a year by Engage Media, Suite 4.08, The Cooperage, 56 Bowman Street, Pyrmont NSW 2009 ABN 50 115 977 421. Views expressed in Bite magazine are not necessarily those of the publisher, editor or Engage Media. Printed by Bright Print Group
For all editorial or advertisingenquiries:Phone (02) 9660 6995 Fax (02) 9518 5600
COVER STORY YOUR BUSINESS YOUR TOOLS YOUR LIFENEWS & EVENTS
04
Dr Karin Alexander has been elected as the new federal president of the Australian Dental Association (ADA). Dr
Alexander succeeds Dr Shane Fryer. Since joining the ADA South Australian Branch (ADASA) Dr Alexander has been actively involved in both branch and national committees. She is highly respected for her previous role as federal vice president over the past two years, and her leadership with the provision of continuing professional development to dentists. Dr Alexander is also well known for her work with the governance review of the Associa-tion, and legislative change.
Dr Alexander says, “The past few years have been ones where dental care delivery has been a significant political issue. Ongoing coordinated reform and action is required by all governments across Australia. I shall be working hard to ensure that the re-form provides effective care to those experiencing difficulty accessing dental care. The Commonwealth Gov-ernment has announced its intention to assume a role in oral health promo-tion, and the ADA is keen to provide the expertise of its member dentists to assist with this. The ADA will con-tinue to push governments to provide funding targeted at improving access to dental care for disadvantaged Aus-tralians. I also want to ensure that the ADA continues to serve its members well. These are challenging times for all membership organisations, and the ADA must strive to anticipate the needs of its members.”
Dr Alexander became a Fellow of the Academy of Dentistry Interna-tional (2003), a Fellow of the Inter-national College of Dentists (2003), and a Fellow of the Pierre Fauchard Academy (2005). She is an Associate Fellow of the Australasian Council of Health Service Management (2008).
Dr Alexander is the first female president of the ADA. In an official
statement, the ADA also welcomed the newly appointed federal execu-tive, Dr Carmelo Bonanno as vice president and Drs Rick Olive, Hugo Sachs and Terry Pitsikas.
Following her election as presi-dent, Dr Alexander paid tribute to the ADA’s previous president Dr Shane Fryer for his energy, leader-ship and significant contribution to critical dental issues.
“Dr Fryer has done much for Aus-tralian dentistry during his term. His work on the National Advisory Coun-cil on Dental Health was immense. This, together with his promotion of the ADA’s Dental Access program, will help governments formulate the correct solutions for the improve-ment of Australia’s dental health,” Dr Alexander says. “The ADA has two main objectives: the promotion of the art and science of dentistry by en-hancing its members’ ability to pro-vide safe, high quality professional oral care and the improvement of the oral health of the community. I shall lead the ADA to continue the hard work that has occurred in achieving these objectives, and will do my best to meet the challenges that confront Australia’s dental health.”
Changing of the guardThe Australian Dental Association has elected a new president to steer it through challenging times
Dr Karin Alexander, the new President of the ADA.
Dental profession growing, says AHPRAThe annual report of the Australian Health Practitioner Regulation Agency (AHPRA) and the National Boards has been published, and it shows the dental profession is the second-fastest growing medical profession (behind physiothera-pists). AHPRA estimates that dentists, dental specialists, dental therapists, dental hygienists, oral health therapists and dental prosthetists, who make up the dental profession, increased in num-ber by 4.19 per cent to 19,087 in the last year. AHPRA renewed the registration of 557,000 health practitioners during the year, including the biggest ever health practitioner renewal in Australia when more than 330,000 nurses and midwives renewed by May 2012. Its data reveals that 13 per cent of all registered health practitioners are aged 50–54 years, and there were 58,620 practitioners with specialist registration across three professions (dental practice, medi-cal practice and podiatry) on 30 June 2012. Of these, only 1,541 practitioners were registered to practise in a dental specialty—the vast majority of the rest were in a medical specialty.
AHPRA CEO, Mr Martin Fletcher, says the 2012 annual report revealed the scope of AHPRA’s work, with one in every 39 Australians a registered health practitioner. “The numbers in the annual report are large, indicating the National Scheme is working very smoothly and at a scale never before undertaken in Aus-tralia in health practitioner regulation,” he says. The report reveals: • The number of registered health practitioners in Australia increased by more than three per cent (18,000) to 548,000 by June 2012, including 3,355 more doctors • There were 7,594 notifications (concerns) about health practitioners made in 2012; 775 of them were manda-tory reports. The number and type of voluntary notifications made was broadly consistent with 2011. • Of more than 68,000 criminal history checks conducted, 400 were assessed as having the potential to affect registration, and the registration of nine practitioners was restricted or refused as a result.
BROUGHT TO YOU BY THE MAKERS OF PANADEINE® EXTRA IN THE INTEREST OF THE QUALITY USE OF MEDICINES. Panadeine® Extra contains paracetamol 500 mg and codeine phosphate 15 mg. Use: For the temporary relief from moderate to severe pain. Contraindications: Hypersensitivity to any ingredient in the product; children under 12 years. Dosage: Adults and children 12 years and over: 2 caplets every 4–6 hours orally with water; (maximum 8 caplets in 24 hours). Precautions: CNS, respiratory depression; high doses, prolonged use; renal, hepatic Impairment; poor CYP2D6 function; pregnancy, lactation. Adverse reactions: Dependence; Impairment of mental & physical abilities; nausea, vomiting, constipation; dizziness, drowsiness. Interactions: Anticoagulants; sedatives, tranquilisers; drugs affecting gastric emptying; chloramphenicol; hepatic enzyme inducers; CYP2D6 inhibitors. Please review full Product Information (PI) before recommending Panadeine Extra. The full PI is available from GlaxoSmithKline Consumer Healthcare on request (FREECALL 1800 028 533). Panadeine® and the Panadeine Vibration™ are trade marks of the GlaxoSmithKline group of companies. GlaxoSmithKline Consumer Healthcare. 82 Hughes Avenue, Ermington, NSW 2115. 1800 028 533. GSK0164/BIT/UCReferences: 1. Hargreaves K, Abbott P. Aust Dent J 2005; 50(s2): S14–S22. 2. Beaver WT. Am J Med 1984; 77(3A): 38–53. 3. Oral and Dental Expert Group. Therapeutic Guidelines: Oral and Dental. Version 1. Melbourne: Therapeutic Guidelines Limited; 2007. 4. Macleod G, et al. Aust Dent J 2002; 47: 147–51. 5. Comfort MB, et al. Aust Dent J 2002; 47: 327–330. 6. Bentley K, et al. Curr Ther Res 1991; 49: 147–54.
Media
n ch
ange
in p
ain in
tens
ity (c
m/h)
2.01.81.61.41.21.00.80.60.40.2
0Paracetamol
(500 mg tablet x 2)
1.81
Paracetamol/codeine(500 mg/15 mg tablet x 2)
0.45
Adapted from McCleod et al. 2002 4
Figure 1: Median change in pain intensity with paracetamol + codeine vs. paracetamol alone (n=82)4
Panadeine Extra is the strongest analgesic available
without a prescription based on codeine content per dose
Single-agent analgesia may not be sufficient to achieve adequate pain relief.1
Paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs, like ibuprofen) can be used for the temporary relief of dental pain,2,3 however single-agent analgesic therapy may not always be sufficient to achieve adequate pain relief.1
A combination of analgesics that work in different ways – like paracetamol and codeine may be beneficial.This is because a combination of analgesics that have two different modes of action can enable an increase in analgesia whilst minimising side effects.3,4 In some patients it may be appropriate to offer a fixed-dose paracetamol/codeine combination rather than an NSAID or NSAID/codeine combination for the management of stronger pain, particularly for patients in whom NSAIDs are contraindicated.3
Strengthen your recommendation in dental pain relief with Panadeine ExtraPanadeine Extra has been specially formulated, by combining the strength of codeine phosphate (15 mg) with paracetamol (500 mg) per tablet to provide fast, effective temporary relief from strong pain. Panadeine Extra contains the highest OTC dose of codeine (15 mg of codeine phosphate), making it the strongest pain reliever available without a prescription.
Paracetamol/codeine combinations have been clinically proven in post-operative dental pain4–6
Several clinical studies have provided evidence of effective pain relief when paracetamol is combined with a low codeine dose.4–6
In a study of patients who had undergone surgical removal of impacted third molars, paracetamol + codeine phosphate (500 mg/15 mg tablet x 2) [e.g. Panadeine Extra] provided significant improvement in post-operative pain relief over paracetamol (500 mg tablet x 2) alone (p=0.03), with no significant difference in side effects over 12 hours.4
“...there is a significant improvement in postoperative pain relief following this combination [paracetamol 1000 mg plus codeine 30 mg]”4
Another study (n=139) compared the efficacy of a single tablet of either paracetamol/codeine phosphate (300 mg/15 mg), paracetamol/codeine phosphate (300 mg/30 mg), floctafenine (400 mg) or placebo for the relief of pain following dental surgery.6 All three treatments were significantly superior to placebo (p=0.0001).6
A later study of 232 patients who underwent impacted third molar surgery, received either paracetamol + codeine phosphate (500 mg/8 mg x 2 tablets) taken every 4–6 hours or the NSAIDs etodolac (200 mg x 2 tablets taken every 6–8 hours) or diflunisal (250 mg x2 tablets taken every 8–12 hours).5 All three drugs were found to be effective in the control of post-operative pain.5
So the next time a patient requires proven relief from dental pain4–6 – consider recommending Panadeine Extra
BROUGHT TO YOU BY THE MAKERS OF PANADEINE® EXTRA IN THE INTEREST OF THE QUALITY USE OF MEDICINES. Panadeine® Extra contains paracetamol 500 mg and codeine phosphate 15 mg. Use: For the temporary relief from moderate to severe pain. Contraindications: Hypersensitivity to any ingredient in the product; children under 12 years. Dosage: Adults and children 12 years and over: 2 caplets every 4–6 hours orally with water; (maximum 8 caplets in 24 hours). Precautions: CNS, respiratory depression; high doses, prolonged use; renal, hepatic Impairment; poor CYP2D6 function; pregnancy, lactation. Adverse reactions: Dependence; Impairment of mental & physical abilities; nausea, vomiting, constipation; dizziness, drowsiness. Interactions: Anticoagulants; sedatives, tranquilisers; drugs affecting gastric emptying; chloramphenicol; hepatic enzyme inducers; CYP2D6 inhibitors. Please review full Product Information (PI) before recommending Panadeine Extra. The full PI is available from GlaxoSmithKline Consumer Healthcare on request (FREECALL 1800 028 533). Panadeine® and the Panadeine Vibration™ are trade marks of the GlaxoSmithKline group of companies. GlaxoSmithKline Consumer Healthcare. 82 Hughes Avenue, Ermington, NSW 2115. 1800 028 533. GSK0164/BIT/UCReferences: 1. Hargreaves K, Abbott P. Aust Dent J 2005; 50(s2): S14–S22. 2. Beaver WT. Am J Med 1984; 77(3A): 38–53. 3. Oral and Dental Expert Group. Therapeutic Guidelines: Oral and Dental. Version 1. Melbourne: Therapeutic Guidelines Limited; 2007. 4. Macleod G, et al. Aust Dent J 2002; 47: 147–51. 5. Comfort MB, et al. Aust Dent J 2002; 47: 327–330. 6. Bentley K, et al. Curr Ther Res 1991; 49: 147–54.
Media
n ch
ange
in p
ain in
tens
ity (c
m/h)
2.01.81.61.41.21.00.80.60.40.2
0Paracetamol
(500 mg tablet x 2)
1.81
Paracetamol/codeine(500 mg/15 mg tablet x 2)
0.45
Adapted from McCleod et al. 2002 4
Figure 1: Median change in pain intensity with paracetamol + codeine vs. paracetamol alone (n=82)4
Panadeine Extra is the strongest analgesic available
without a prescription based on codeine content per dose
Single-agent analgesia may not be sufficient to achieve adequate pain relief.1
Paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs, like ibuprofen) can be used for the temporary relief of dental pain,2,3 however single-agent analgesic therapy may not always be sufficient to achieve adequate pain relief.1
A combination of analgesics that work in different ways – like paracetamol and codeine may be beneficial.This is because a combination of analgesics that have two different modes of action can enable an increase in analgesia whilst minimising side effects.3,4 In some patients it may be appropriate to offer a fixed-dose paracetamol/codeine combination rather than an NSAID or NSAID/codeine combination for the management of stronger pain, particularly for patients in whom NSAIDs are contraindicated.3
Strengthen your recommendation in dental pain relief with Panadeine ExtraPanadeine Extra has been specially formulated, by combining the strength of codeine phosphate (15 mg) with paracetamol (500 mg) per tablet to provide fast, effective temporary relief from strong pain. Panadeine Extra contains the highest OTC dose of codeine (15 mg of codeine phosphate), making it the strongest pain reliever available without a prescription.
Paracetamol/codeine combinations have been clinically proven in post-operative dental pain4–6
Several clinical studies have provided evidence of effective pain relief when paracetamol is combined with a low codeine dose.4–6
In a study of patients who had undergone surgical removal of impacted third molars, paracetamol + codeine phosphate (500 mg/15 mg tablet x 2) [e.g. Panadeine Extra] provided significant improvement in post-operative pain relief over paracetamol (500 mg tablet x 2) alone (p=0.03), with no significant difference in side effects over 12 hours.4
“...there is a significant improvement in postoperative pain relief following this combination [paracetamol 1000 mg plus codeine 30 mg]”4
Another study (n=139) compared the efficacy of a single tablet of either paracetamol/codeine phosphate (300 mg/15 mg), paracetamol/codeine phosphate (300 mg/30 mg), floctafenine (400 mg) or placebo for the relief of pain following dental surgery.6 All three treatments were significantly superior to placebo (p=0.0001).6
A later study of 232 patients who underwent impacted third molar surgery, received either paracetamol + codeine phosphate (500 mg/8 mg x 2 tablets) taken every 4–6 hours or the NSAIDs etodolac (200 mg x 2 tablets taken every 6–8 hours) or diflunisal (250 mg x2 tablets taken every 8–12 hours).5 All three drugs were found to be effective in the control of post-operative pain.5
So the next time a patient requires proven relief from dental pain4–6 – consider recommending Panadeine Extra
COVER STORY YOUR BUSINESS YOUR TOOLS YOUR LIFENEWS & EVENTS
06
Research strengthens link be-tween obesity and dental health in homeless childrenObesity and dental cavities increase and become epidemic as children living below the poverty level age, according to nurse researchers from the Case Western Reserve University and the University of Akron, both in Ohio, USA.
“It’s the leading cause of chronic infections in children,” said Marguerite DiMarco, associate professor at the Frances Payne Bolton School of Nursing at Case Western Reserve University. “Many people do not realise,” she said, “that dental caries is an infectious disease that can be transmitted from the primary caregiver and siblings to other children.”
To help reduce the spread of dental infection, DiMarco reminds parents that gum disease and other oral infections can be spread by licking a child’s spoon or baby bottle, or by sharing toothbrushes.
Researchers found that as body mass index (BMI) in-creased with age, so do the number of cavities. These findings were published in the online Journal of Pediatric Health Care article, “Childhood obesity and dental caries in homeless children”.
The study examined the physicals of 157 children, from two to 17 years old, at an urban homeless shelter. Most were from single-parent families headed by women with one or two children.
Half the population ignores mouth cancer symptoms
Half of the population would leave a non-healing mouth ulcer longer than recommended, potentially leaving a mouth can-cer symptom going undetected, according to new research conducted by the British Dental Health Foundation. A survey of 2044 people found only 49 per cent of people would seek medical advice within less than four weeks if they had a mouth ulcer. More than one in three (37 per cent) would seek medical advice within one-to-two months, and of even great-er concern one in 14 people (seven per cent) would leave it longer than three months. The results are in stark contrast to other signs and symptoms of the disease. Almost three in every four people (71 per cent) would seek medical advice within four weeks if they had an unusual lump or swelling, and a similar amount (69 per cent) would do likewise if they noticed red and white patches in the mouth. The results make for worrying reading. Chief executive Dr Nigel Carter OBE said: “It is of great concern that only half of the people know how long they should wait before seeking medical ad-vice over a mouth ulcer. Early detection is absolutely crucial in transforming survival rates, and those leaving a mouth ulcer longer than three weeks are potentially risking a late diagnosis, something that reduces five-year survival rates to as low as 50 per cent. With the benefit of early diagnosis, survival rates can increase to up to 90 per cent.”
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Gene therapy can be performed safely in the human salivary gland, according to scientists at the National Institute of Den-tal and Craniofacial Research (NIDCR), part of the National Institutes of Health in Maryland, USA.
This finding comes from the first-ever safety, or Phase I, clinical study of gene therapy in a human salivary gland. Its results, published in the Proceedings of the National Acade-my of Sciences, also show that the transferred gene, Aqua-porin-1, has great potential to help head and neck cancer survivors who battle with chronic dry mouth. Aquaporin-1 encodes a protein that naturally forms pore-like water chan-nels in the membranes of cells to help move fluid, such as oc-curs when salivary gland cells secrete saliva into the mouth.
The scientists gave 11 head and neck cancer survivors a single-dose injection of the Aquaporin-1 gene directly into one of their two parotid salivary glands, the largest of the major salivary glands. The gene was packaged in a disabled, non-replicating adenovirus, the cause of the common cold when intact but incapable of causing a cold in this case. As is standard in gene therapy studies, the virus served as the vector, or Trojan horse, to deliver the gene into the cells lining the salivary gland. The scientists found that five participants had increased levels of saliva secretion, as well as a renewed sense of moisture and lubrication in their mouths, within the study’s first 42 days, the period covered in this report.
Can Nisin stop cancer?
Nisin, a common food preservative, may slow or stop squa-mous cell head and neck cancers, a University of Michigan study found. What makes this particularly good news is that the US Food and Drug Administration and the World Health Organization approved nisin as safe for human consumption decades ago, says Yvonne Kapila, the study’s principal in-vestigator and professor at the University of Michigan School of Dentistry. This means that obtaining FDA approval to test nisin’s suggested cancer-fighting properties on patients in a clinical setting won’t take as long as a new therapy that hasn’t been tried yet on people, she says.
“The poor five-year survival rates for oral cancer under-score the need to find new therapies for oral cancer,” Kapila said. “The use of small antibacterial agents, like nisin, to treat cancer is a new approach that holds great promise. Nisin is a perfect example of this potential because it has been used safely in humans for many years, and now the laboratory studies support its anti-tumour potential.”
The U-M study, which looked at the use of antimicrobials to fight cancerous tumours, suggests nisin, in part, slows cell proliferation or causes cell death through the activation of a protein called CHAC1 in cancer cells, a protein known to influence cell death.
The study is the first to show CHAC1’s new role in promot-ing cancer cell death under nisin treatment.
*Please note that Floss-Picks are intended for single use and under these conditions will generally not break, shred or fray.
50 Pack: 50 Individually Wrapped Floss-Picks PAC50 $3.75 $3.00From the Piksters™ People
• NEW SUPER strong, PTFE (like TeflonTM) floss can clean the whole mouth without shredding or breaking
• Excellent for tight and rough contacts - slides easily around teeth without shredding
• Gentle around delicate papillas
• Floss and Toothpick in one
• Easier to use than standard floss - no winding floss around fingers
• Preferred alternative to regular floss
Copy of ED BITE 1-2 ADVERT DEC 2012 Intraoral repair kit.indd 1 6/12/2012 2:15:24 PM
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NEWS & EVENTS COVER STORY YOuR buSiNESS YOuR LiFEYOuR TOOLS
New indications and forms of application for SDR®SDR® now available in syringes
In 2010 SDR flowable composite base material was successfully intro-duced in a Compula® form. Thanks to its extremely low polymerization stress, this bulk-fill posterior composite base material is self-leveling and adapts perfectly to the cavity walls. Unlike conven-tional flowables, SDR can be applied in increments of 4mm in one step. SDR can be capped with any composite.
SDR is designed for use as a base in large class I and class II cavities – and now also as a liner for smaller class I cavities or as a fissure sealant, as well as for filling defects or under-cuts in tooth preparations for crowns, inlays or onlays.
With three years of clinical evidence behind it, SDR has become a world success, having been used for direct dental restorations in millions of cases. From October 2012, SDR will also be available in a pre-filled syringe, making the ap-plication of this composite material even more flexible for the dentist.
To arrange a demonstra-tion or to find out more, please contact your local DENTSPLY Sales Specialist or our Client Services team on 1300 55 29 29 (Austra-lia) or 0800 DENTSPLY (33 68 77) (New Zealand).
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Controlled Arch Aust Dentist_V2.indd 1 30/11/12 11:20 AM
NEWS & EVENTS COVER STORY YOUR TOOLS YOUR LIFE
010
YOUR WORLD
10
The Kimberley is a vast expanse of land, twice the size of Victoria yet it is home to just 35,000 people. This isolation brings many challenges, and in the three years to 2009, Halls Creek, the biggest town in the region, had rarely seen a visiting dentist and never had a permanent dentist. That’s
the year that Jan and Dr John Owen wandered into the town and realised they were witnessing an oral health crisis.
No more shocking was finding that in Halls Creek 75 per cent of the primary school children showed signs of advanced decay.
As an emergency response the couple set up the Kimber-ley Dental Team (KDT) and asked their peers to drop their cushy lifestyle, particularly their dinners at fancy restau-rants, to dedicate time and skills to turn this crisis around.
It is a two-hour drive along the gravel road from Halls Creek to Ringers Soak, a tiny indigenous community of 200 residents. On arrival Dr Jilen Patel, one of the KDT volunteers, opens the door of his four-wheel drive causing thick red dust to fall off the window. He emerges fresh and very smart, ready to draw together from the most meagre of resources in a modern, though minimal, dental clinic.
One day this year was particularly memorable. A five-year old girl emerged with a swollen face, the pain in her eyes was excruciating. For months she had been too sick
to play or go to school and now she was unable to eat. “By the look in her eye, then opening her mouth, it was clear that she had not had a day free from chronic pain for many months, possibly years,” says Dr Patel.
It was almost 40 degrees as sun pelted down onto the metal roofs in this town that is situated in the far northern
regions of Western Australia. Yet against the odds a veranda was re-designed into a dental clinic, with one end being a dentist surgery, the other end were rows of old wooden chairs creating a waiting room.
Despite the challenges this tiny girl sat through the pro-cess as Dr Patel removed two rotting teeth.
“The next day I saw her playing with her friends around the community store so she showed me around the area. She was feeling fantastic; there was life in her face again. That was priceless,” says Dr Patel.
Fly-in dentistsDr John and Jan Owen have established a fly-in clinic in the Kimberley where dentists can learn how to deal with some of the worst oral health problems they’re likely to face. By Mary Banfield
“When we started 95 per cent of our work was emergency care … now we are down to about 45-50 per cent.”
Quote Dr John Owen
YOUR WORLD
This was the third of Dr Patel’s visits to the Kimberley. His first was in 2009 when he was a final-year dental intern at the University of Western Australia. Since then he has devel-oped a passion for leaving his comfortable, family practice in suburban Perth to enter a world that was described by the man who set up the KDT, Dr Owen, as “very close to the middle of bloody nowhere”.
The isolation is the problem and without the KDT service, residents of the Kimberley face having to travel for hun-dreds of kilometres to see a dentist. With most families in the area living on the pension, the cost of dental work, even if it is subsidised, is prohibitive.
That’s the problem that Dr Owen was determined to overcome after seeing for himself the consequences of a neglected dental service.
In the past, children would develop tooth decay that was left untreated until an infection developed. The only option for GPs was to prescribe repeated courses of antibiotics and painkillers until it became so bad the patient had to be transported to hospital, possibly in Perth.
In 2010, 56 per cent of Kimberley primary school chil-dren desperately need dental work, and 38 per cent of those required immediate attention, with abscesses and
gross caries; the remaining ones needed work within six months.
The dental health problems in the Kimberley are not unique. As part of the Northern Territory Intervention, re-search on the state of indigenous children’s oral health was carried out and the results were astonishing.
“Fifty-two per cent of children who received a Child Health Check Initiative (Closing the Gap) program funded dental service were diagnosed with decay. Analysis of data on decayed, missing and filled teeth shows that before their third birthday, 66 per cent of children had caries experi-ence (decay, missing or filled teeth). This was 93 per cent for children aged six years,” says Dr Fadwa Al-Yaman from the Australian Institute of Health and Welfare.
The challenge of turning the crisis around in the Kimber-ley has been enormous so it required a significant financial investment from the Owen Family Trust. Each weekly trip costs $14,000, but for Dr Owen, the investment has pro-vided an enormous social return. After five years of flying visits, the KDT is now able to focus on prevention. “When we started 95 per cent of our work was emergency care—extraction surgery—and now we are down to about 45-50 per cent,” he says. Thanks to corporate sponsorship four times a year every child receives a new toothbrush and toothpaste, and one for each member of their family.
As Dr Patel talks from his air-conditioned surgery in Perth he won’t ever be drawn into what it’s like being confronted
Jan and Dr John Owen, who established the Kimberley Dental Team that’s “very close to the middle of bloody nowhere”.
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with such poverty and enormous social problems. He only sees the positives.
Today care in the outback has been made a little easier with KDT hav-ing access to a purpose-built truck, owned by the Kimberley Aboriginal Medical Services Council. “We now have the luxury of having a fully op-erational dental unit with all your top spec equipment,” says Dr Patel—one that even provides overnight accom-modation.
Although that comes down to inter-pretation. “The truck is built for the bitumen and didn’t ‘survive’ the rough conditions of the Tanami Desert Road from Halls Creek to Alice Springs. A recent trip over 170 kilometres took eight hours and when we opened the doors of the mobile clinic, the floor was littered with nuts and bolts and dental chairs had fallen apart,” says Dr Owen.
What they both agree on is that each volunteer comes back to their city job with highly developed prob-lem solving skills. Without access to
the most basic equipment including an autoclave, the same standard of care is expected whether the service is under a tree in Warmun or Macqua-rie Street, Sydney.
How do you remove a 14-year-old’s molars in the kitchen of a disused school? How do you perform the surgery in front of her five siblings
who follow you around a dental deck chair that is heightened by a platform precariously placed underneath?
Dr Owen believes that being able to overcome these challenges are indispensible to any dentist. “We tell our students, you have to have the confidence to get into trouble to be able to get out of trouble,” he says.
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NEWS & EVENTS YOUR BUSINESS YOUR TOOLS YOUR LIFECOVER STORY
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Many dentists would be happy not having to deal with either special needs patients, or those with intense dental phobia. Dr Avanti Karve has made a career out of dealing with both. By Andy Kollmorgen
udging by her contributions to the profession so far, the first graduate of Sydney Univer-sity’s Special Needs Dentistry program, Dr Avanti Karve, will be taking dentistry in a new direction between now and the time she retires. Fortunately for the patients she looks after these days, it will
be a while before that happens. Dr Karve has an agenda, and her determination to make a difference is hard to miss when she talks about her work.
Dr Karve thinks it’s time for Australian dentistry to start moving away from its longstanding fixation on a strictly medical model of oral care and start embracing a more holistic approach—that is, to get on board with the evolving arc of healthcare as a whole. As with patients of all kinds, most dental patients would be better served, Dr Karve says, if practitioners looked beyond the immediate oral health issues at hand and concentrated more on what might be causing them. Then again, most dental practitioners in Australia (and many other countries) have had little time or opportunity to deliver this sort of multi-dimensional care. And here especially, holistic case management involving other
medical and allied health professionals hasn’t been part of the culture. Dr Karve aims to change that, and she has started in a place where change is long overdue.
One lesson from the Sydney Uni program was particularly clear: Nowhere is a holistic view of the patient more crucial than when treating those who are relegated to the broadly defined category known as special needs. It’s a catch-all phrase that includes people with intel-lectual or physical disabilities, mental illnesses, neurodegenerative diseases like Parkinson’s and Huntington’s, various forms of dementia, and more. And it’s a patient pool whose numbers are growing.
For Dr Karve, this area of unmet need has sparked an enviable professional leap—she seems to have channelled her daily working life into an overarching career goal. The interest goes back to her graduation from the University of Ad-elaide’s School of Dentistry in 2003. “I was always interested in managing medically complex patients,” she says.
But it wasn’t until she undertook a residency in special needs dentistry at Westmead Hospital and signed up for the three-year Doctorate of Clinical Dentistry (SND) program at Sydney Uni that she understood how isolated special needs patients are from mainstream dentistry. “It’s a very challenging and unique area, and we have strong longstanding evidence that this group is being underserved.”
Special needs patients have been left out of the loop for a variety of reasons, from the practical to the discriminatory, Dr Karve points out. Practices may not be equipped to handle patients with a mental illness, a degenerative health condition, someone confined to a wheelchair, or someone in their 90s who finds dental treatment difficult. Or practices may simply not want to deal with such patients. “They are difficult to manage and chal-lenging to treat, and this puts off a lot of general practitioners,” Dr Karve says. The statistics bear out the expected results: special needs patients have markedly poorer dental health.
The special needs category also includes phobic patients, a specialty of Dr Karve’s and an area, she says, that’s both ripe for further investigation and rife with misconceptions. While up to 40 per cent of patients in the western world suffer from dental anxiety to varying degrees, according to one recent survey, only 5 to 10 per cent are afflicted with debilitating fear—the kind that prevents would-be patients from visiting a dentist even in the face of debilitating pain. The numbers are far from solid, however. “The statistics are quite difficult to interpret,” is how Dr Karve puts it.
Though the research-based science has moved on from the 1970s notion that dental phobia was rooted solely in painful dental experiences, the question
COVER STORY
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of what causes such fear continues to elude a definitive answer. What is clear, though, is that an encounter with an inept practitioner is unlikely to engender a lifelong fear of dental care. In the US, researchers are also looking at a range of potential fear factors, with a focus on using the same tools to manage dental phobia as post-traumatic stress disorder. It’s a move away from earlier European studies that have attributed dental pho-bia to inherent personality traits, and a step in the right direction, Dr Karve says.
She hopes any legacy she leaves will include the understanding that dental phobia should be looked at separately from dental health and considered in the same light as other phobias, such as an overwhelming aversion to germs or needles or claustrophobia, agoraphobia and other tricks of the mind.
“We’ve had patients who’ve never had dental treatment in the past who are dentally phobic,” Dr Karve says. “You’re in a confined space in a vulnerable posi-tion and, obviously, the mouth is a very personal area. The fear may somehow be rooted in your sense of self, your sense of personal space.”
survey-based study published in the European Journal of Oral Science in 2009 compared the
incidence of dental phobia to that of 10 other common fears among 1,959 Dutch adults aged 18 to 93. The prevalence of dental fear (another word for anxiety in this context) was 24.3 per cent, trailing behind fear of snakes, heights, and physical injuries (34.8 per cent, 30.8 per cent and 27.2 per cent, respectively). But when it came to full-fledged phobias, dental phobia was the most widespread (3.7 per cent), followed by heights (3.1 per cent) and spiders (2.7 per cent). The study found that dental fear is “a remarkably severe and stable condition with a long dura-tion”, especially among females.
In a survey study published in the Australian Dental Journal in 2010, there was some common ground when it came to causation. Dental phobia across the social spectrum was “significantly associated” with concerns about injec-tions, but the prospect of financial damage was even more scary. Cost of treatment was the most anxiety-produc-ing worry of all in the study.
Trying to gain a clinical understand-ing of how best to treat special needs patients beyond survey exercise has built-in problems. Ideally, evidence that might make its way into treatment op-tions would be drawn from randomised trials. But the patients needed to make such trials worthwhile are the least likely to take part. “We’re very much at
the stage of case-control studies, and because there’s such a wide range of patients in each field, it’s a challenge to design studies, and to find participants,” Dr Karve says. “A callout for participants in a dental phobia trial is going to have a low response rate because the priority for these patients is to avoid dentists.”
One trial has gotten off the ground, however—one that Dr Karve coordinated through the Dental Phobia Clinic at the Westmead Centre for Oral Health. Dr Karve’s treatise came to the conclusion that women in their 40s are more likely than other age groups to suffer from dental anxiety as defined by Norman Co-rah’s Modified Dental Anxiety Scale (in use since the mid-20th century).
The study wasn’t designed to explore the full range of possible causes, but it
did detect a link between previous head and neck trauma and fear of visiting the dentist. The emotional scar didn’t neces-sarily have anything to do with dentistry.
Despite the gaps in special needs care, Australian dentistry has been moving in the right direction in recent decades, Dr Karve acknowledges. Most dental school curriculums have included a special needs or behavioural component for the past 20 or 30 years, generally in the fourth year of study. But the training hasn’t been enough to keep pace with the complexities of the chal-lenge. The Australian Society of Special Care in Dentistry (ASSCID), where Dr Karve currently serves as secretary, is an initiative to bring like-minded prac-titioners together in order to increase lobbying power as well as maximise other resources. In partnership with the Australia New Zealand Academy of Special Needs Dentistry, ASSCID hosted the International Association for Disability and Oral Health Congress in Melbourne in October.
When it comes to hands-on help, Dr Karve divides her time these days between the Special Care Unit at Westmead Hospital and Norwest Special
Needs Dentistry in the Sydney suburb of Bella Vista and The Dental Specialists practice in Sydney. Her special needs patients come from most points on the socioeconomic and demographic spectrum, but there is a link: It’s harder for them to get good treatment than the rest of the patient population. Dr Karve believes it’s a problem that can only get worse without a wider awareness of the obstacles they face and a strategy to deal with them. Such patients have longer life expectancy than ever, without a corresponding increase in dental services attuned to their needs. “We know we have an ageing population and increased retention of teeth,” Dr Karve says. “So we’re going to have to manage a new set of patients who have a long-term set of problems.”
COVER STORY
“We’ve had patients who’ve never had dental treatment in the past who are dentally phobic.”
QuoteDr Avanti Karve
Dr Avanti Karve at the Westmead Centre for Oral Health in Sydney.
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any dentists dream of retiring ‘one day’, but often it is not until they wake up (one day) and decide that time has come and they finally decide to do something about it. Simon Palmer of Dentist Job Search (DJS), a special-ist dental employment and
practice sale service, says that preparation is essential for sus-taining the momentum required to finalise a sale. “It’s concerning to the buyer when the financials are not readily available—how-ever it is surprisingly common for potential buyers to have to wait for the accountant to finish with the financials,” he says. The problem with these sorts of delays, says Palmer, is that the buyer ends up losing interest, finding other options, or simply backing away believing that the vendor is not serious about selling.
While financial details will be the buyers’ primary concern, the aesthetics will also play a major role in securing a sale. “It’s like selling a house or apartment… it’s an emotional decision as well as a financial one,” says Palmer. “When they walk through they are trying to imagine the feeling they will get when working there.” If it has been a long time since the practice was refit, Palmer advises spending a couple of thousand dollars on a coat of paint and some new furniture. Particular attention should then be paid to the areas that will be used the most or that will impact
on the first impression, such as the reception and waiting areas.Graham Middleton of The Synstrat Group has been advising
dental practitioners on strategic processes, practice manage-ment and practice valuation for over 25 years, and says that many dentists who are approaching retirement age are reluc-tant to invest in their practices in this way and, as a result, the practices start to look like they’re falling apart. “Buying new
equipment four or five years out from sale will ensure you get good capital returns,” says Middleton. “The only trouble is, no- one knows five years in advance that they want to sell.”
What is essential, then, is to come up with an exit strategy well in advance of the decision to sell. Since smooth handover is an essential component of the value of your practice, Middle-ton says your exit strategy can incorporate a period of ‘semi-
On the listIf you’re considering selling your practice, you should prepare for the sale. Here, the experts give their tips on how to run your practice so that it’s ready to go when you are. Amanda Lohan reports.
“Buying new equipment four or five years out from sale will ensure you get good capital returns.”
Quote Graham Middleton, The Synstrat Group
YOUR BUSINESS
retirement’, during which you keep your name on the wall but gradually phase yourself out to reduce patient attrition.
Your exit strategy should begin with benchmarking your practice against the competition at least 18 months prior to listing. “Most dentists tend to operate as little islands and don’t really know how their practice compares to everyone else,” says Middelton. “But you can’t fatten the pig the day before you take it to market.” By benchmarking your practice, you can identify issues that may impact on the value of your practice with enough time to address these issues before listing. This may include negotiating a longer lease, reassessing the appropriate-ness of current staffing arrangements and fees, or investing in new fittings and equipment.
The end goal, says Middleton, is to demonstrate continuously improving financial performance in the years leading up to the sale. Essential to this process is the untangling of any personal investments, clearly separating, for example, the salary and superannuation for yourself and your spouse, and any personal shares or property.
Once these things have been done, Middleton says the next step is to obtain an accurate valuation from a valuer specialis-ing in dental practices. A good valuer, he says, will look at the
value of similar practices bought and sold in a similar area and ask “What is the practice doing right now and what will be maintainable?” The key is to discover not the highest price, but the optimum price.
The disadvantages of under-pricing are obvious, but Middle-ton says overpricing can be just as harmful. “You don’t want to overprice your practice because you can’t lower the price later on and expect everyone to come back,” he says.
Any valuation performed in the current climate should take into account the surplus of dentists and how this will impact on the future growth and fee-earning capacity of the business. “At the rate we’re producing dentists… practices can hold onto existing patients, but their ability to grow in the face of competi-tion is pretty doubtful,” says Middleton.
Palmer agrees, adding that there are around 65 practices listed for sale with DJS and around 350 registered, active buy-ers. “About eight years ago we had close to 100 practices for sale and about 100 registered buyers,” he says. “The ratios have shifted and I would say it’s much more of a seller’s market right now than it has been in the past.”
While, however, a surplus of demand can lead to higher prices for sellers, Palmer cautions that strong preparation is still required to achieve the optimum possible price for each individual practice. “The decision to list is usually an emotional one. It is essential that when a dentist gets to that threshold and they decide to sell, they are fully prepared,” he says.
Your exit strategy from your practice should begin at least a year-and-a-half prior to listing it for sale.
Essential documentsSimon Palmer of Dentist Job Search advises that poten-tial vendors prepare in advance of listing their practice for sale by obtaining the following documents:
Profit and loss statements for the last three years A list of equipment of note A floor plan Evidence of security of tenure on the lease for
the premises and any major equipment Depreciation schedules Fee schedules Photos of the practice Employee agreements for staff.
More informationGraham Middleton’s booklet, Buying and Selling General & Specialist Dental Practices is available for free from The Synstrat Group at www.synstrat.com.au. The booklet includes a checklist of essential steps in preparing a practice for sale.
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NEWS & EVENTS COVER STORY YOUR TOOLS YOUR LIFE
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The notion that ‘form follows function’ might be more readily associated with 20th-century modernist architects and industrial
designers but, for dentist Dr Hieu Le, it became the foundation for his new surgery in Brisbane’s West End.Originally expressed by Louis Sullivan,
an early mentor to American architect Frank Lloyd Wright, the principle dictated that the shape of a building or object should be determined by its purpose. Though the theories of archi-tecture were not exactly top of mind for Dr Le, what fell out of his brief to Tonic, the Brisbane-based architecture firm, was the aesthetics of his surgery must be derived from its clinical nature.
The result is a modern, stark, white surgery with a visual emphasis on horizontal and vertical lines and floating cabinetry. Tonic director Matt Riley says his client’s brief was white, white and more white—to reflect a clean and sterile environment.
“Patients are looking for subliminal cues for clean and professional sur-roundings, particularly in surgeries,” says Riley. “The difference is, we
Internal affairsInnovative dental surgery design can act as an extension of your practice’s brand identity. But it must be true to the ethos of the practice. By Sarah Hollingworth
Above and opposite: Dr Hieu Le’s brief to his architects was for the design of his Brisbane surgery to reflect a clean, sterile environment.
YOUR bUSINESS
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carried the white all the way through to the main reception and waiting areas—we felt there wasn’t the need to separate the spaces.”
But far from being white, clinical and alienating, the 100-square-metre space has an air of tranquillity; something Tonic thought would be a drawcard for a brand-new practice looking to attract patients.
Just off busy Boundary Street in Brisbane’s distinctly cutting-edge inner-city suburb of West End, Le Tooth (a play on Dr Le’s surname, rather than any Gallic reference) is situated on the corner of a small shopping complex. The premises—seemingly more befitting of a retail space than a dental surgery—contains three dental chairs, sterilisation and OPG rooms, staffroom, office, consulting room and reception and waiting areas.
“There was a lot of pushing and pulling of space,” admits Riley, “but it actually feels really spacious.” That’s something he attributes to the light colour palette, which they achieved
through textures of white, rather than flat surfaces. For example, to achieve a clean and smooth finish, Quan-
tum Quartz engineered stone (which, in addition to being styl-ish, is also low maintenance and ultra hygienic) was used for the surgery bench tops and reception desk, and the use of the polished concrete floors brought an invaluable softening to the overall space.
But the real “find”, says Riley, was the window treatment—an extruded, white plastic wall covering. “It has this appear-ance of a cross between the root of a tree and the root of your teeth,” laughs Riley. “It was a cool analogy, but it also added texture to the environment.”
It would have been easy to go overboard with kitsch- but-cute dental references—tooth-shaped chairs very nearly made the shopping list—but it was important to remain true to the function of the space and practice. As such, interior elements are subtle, functional and represent Dr Le’s modern aesthetic.
Dental Lounge, Düsseldorf, GermanyBy Graft (images: Marcus Schwier)With curved walls, ceilings and fixtures, the source of inspiration for this futuristically designed dental surgery was the Aesculapian staff. A symbol of the medical profession (consisting of a branched staff with a single snake twined around it), the use of concave and convex surfaces, combined with lavish swirls in warm hues, cre-ates a soft and calming effect. Meanwhile, cross-like light fittings bring a necessary air of healthcare and wellbeing to the space.
Dental clinic KU64, Kurfürstendamm 64, Berlin, GermanyBy Graft (images: Hiepler & Brunier, Berlin/www.KU64.de)The model of a sand dune landscape was used as a meta-phor for this über dental clinic in Berlin, Germany. Themed in yellow with undulating floors and ceilings (creating symbolic spaces to hide) and a hanging fireplace in the waiting area, the goal of this clinic is to let patients forget about their fears and relax—as if in a spa, cafe or hotel. “A visit to the dentist could be seen as a little journey into wellbeing,” argues the USA and Germany-based architec-tural firm Graft. Extending this concept, the clinic manifests subliminal messages of beauty, health and wellness.
Bloo Dental, Virgina, USABy Forma Design (images: Geoffrey Hodgdon)Inspired by the owner’s love of scuba diving and all things blue (the colour, that is, not the mood!), Bloo Dental in Brambleton, Virginia is a veritable underwater dental theme park—but in a good way. Low ceilings, circular cut-out door-ways and a moving water projection on to the reception area wall create a postmodern submarine-like aesthetic. And, with dark blue banquettes tucked inside the curved-wall segments framing the waiting area’s side wall, this is a waiting room to put even the most anxious patient at ease.
A world of designLike much in the world of design, overseas dental practices are leading the way in in-novative surgery design. Here are a few out-of-the-box examples…
Above: The feeling of space in the Le Tooth surgery is achieved by using different textures of white.
There’s a fish tank between the reception area and consult-ing room—which, Riley points out, adds both movement and a splash of colour. Floating cabinetry houses (or hides, as the case may be) sometimes ominous-looking dental tools. And strategically selected plants and ornaments—including a large tooth, which can be lit-up at night—dramatise the area around the reception desk.
The tooth, says Riley, was something the client found, but it works well. “There’s the word ‘dentist’ on the window,” he says, referring to the distinct ‘Le Tooth Dentist’ signage, “but we decided to get some association that was literal.”
While the design of any dental surgery is only limited by the imagination of the owner, and can act as an extension of the branding identity, experimental and expensive fit-outs are not always appropriate.
Geoff Parkes, director of Dental Advantage Consulting Group, says, while there’s certainly a place for practice brand-ing, authenticity and consistency are paramount.
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“If the surgery design is authentic to the dentist’s person-ality, type of dental practice, the clientele and the location, then that’s fine,” he explains. “That tells the patient, on a subconscious level, what kind of practice they’re in and what they can expect.”
If, on the other hand, it’s not appropriate to the dental practice or clientele, Parkes says the business is more likely to suffer than prosper.
“There will be situations where it’s just not appropriate to be investing that kind of capital,” he says, explaining that a clean surgery with friendly, helpful staff can be just as effec-tive. “Your patients aren’t going to appreciate it and it’s not going to make a difference to your bottomline.”
Likening it to renovating a house, Parkes suggests den-tists ask themselves: am I getting value for money, am I over capitalising, is it consistent with my budget and why am I doing this?
Starting from scratch (having previously worked for another dentist), Dr Le says he specifically considered his potential West End clientele and passers-by.
“It’s very inner city and there’s a huge shift in demo-graphic,” he says, referring to the apartment-dwelling professionals moving to the area. “So I wanted to cater to people who are mindful of aesthetics.”
Eighteen months down the road of his new fit-out, Dr Le concedes he spent more than he intended, but he is very happy with the end product, which also provides an ideal platform to showcase his state-of-art equipment.
“I don’t think many dentists would want to spend that much capital,” he says, “but the books are looking good for a new dental surgery.”
So, in Dr Le’s opinion, has innovative design helped cre-ate a strong identity for his practice?
“Absolutely.”
Dr Le wanted to cater to patients who were mindful of aesthetics in his inner-city practice.
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here are a number of complex and even conflicting aspects to environmental respon-sibility in the health professions. On the one hand there is the need to reduce unneces-sary waste; on the other the imperative that hygiene standards protect patient health.
At an individual practice level, dentists and their staff can implement a number
of measures to reduce waste and increase efficiency—and practices are increasingly opting to do this where possible. But a more effective model of sustainability involves industry-wide, and indeed, global, solutions.
The recently opened three-dentist Australia Dental practice at Clontarf in Queensland has taken the challenge of environmental waste seriously. On its website the practice touts its thorough waste separation and recycling programs and its support of ‘in-novative biodegradable disposable materials’.
“In addition to an amalgam trap, we also have a filtered water system, which means the water used in our equipment and devices is chemically free and, along with the amalgam, isn’t polluting the environment once it enters the waterways,” says practice manager Anita Roe.
Roe runs a paperless office—all patient documentation is stored electronically, using an iPad to record the patient’s medi-cal history and details. Email, rather than faxing, is standard, which reduces paper usage. In addition, the practice doesn’t
print individual business cards, which can be wasteful when a dentist leaves the practice, instead supplying a universal card that any of the dentists can use. Roe says the practice runs a web-based practice program to eliminate the need for a huge server and storage disks, reducing plastic office waste and power usage, and elected to pay for the highest possible percentage of green power when it connected its electricity.
ME Dental, servicing the Toowoomba region of South East
Queensland, opened in 2011 and is one of two Australian practices accredited by the US-based Eco-Dentistry Association. The Eco-Dentistry Association has 800 members worldwide, and provides guidance to dental professionals around the world on how they can create a green dental practice.
“Green habits are widespread in other parts of the community
Green daysHow do you balance environmental responsibility with responsibility to your patients? Susanna Nelson looks at the practices who are thinking globally and acting locally.
“Green habits are widespread in the community but when it came to our profession we found it wasn’t the norm.”
Quote Amy Leicht, practice manager, ME Dental
YOUR bUSINESS
but when it came to our profession we found it really wasn’t the norm,” says practice manager Amy Leicht. “When we looked closely at how a dental practice operates we found there were many ways that we could implement and sustain green practices. Becoming a member of the Eco-Dentistry Association helped us to see where we could make those changes.”
Since it opened, the practice has implemented measures such as Enviropack reusable sterilisation pouches, remote power boards for electrical appliances, sensor lighting for the bathroom, accessible recycling bins, energy-saving hand dryers, reusable suction tips, a water-conserving dental chair set up and LED lighting where possible—for example, in dental chairs and exit lights. It anticipates a ‘silver’ rating from the Eco-Dentistry As-sociation, with room to move to ‘gold’ as it expands.
The endeavours of individual practices around the country demonstrate the commitment many dentists have to sustainabil-ity and professional responsibility, but it is clear that much more can be achieved when the relevant authorities, industry organisa-tions and experts collaborate on best practice.
The overwhelming success of the Dentists for Cleaner Water project, an initiative of the Victorian branch of the ADA (ADAVB) in collaboration with the EPA and the water retailers, demon-
strates the importance of research and planning in successful environmental outcomes. The project’s founder, ADAVB CEO Garry Pearson, says that the willingness of all the partner organ-isations to be involved in the project determined its efficacy and widespread uptake.
The Australia Dental practice is one of a handful of Queensland dental practices to have installed an amalgam sepa-rator system, which removes the pollutant from the waste stream and includes professional waste removal to responsibly dispose of it. By contrast, more than 902 dental surgeries in Victoria have committed to installing international standard-compliant amalgam separators as a direct result of the Dentists for Cleaner Water project, which provided stepped financial incentives ben-efiting early adopters.
In addition to the work conducted by Garry Pearson and the ADAVB to develop the program, Dentists for Cleaner Water was also made possible with the help of the Australian Dental Indus-try Association, along with trade waste collector Sweeney Todd and heavy metal recycler CMA ecocycle, who ensured that the waste was safely collected and recycled.
A national rollout of the program is now on the cards, and the United Nations Environment Program’s (UNEP) Global Mercury Partnership promises to mandate global action on dental waste management through a global, legally binding instrument on mercury, expected in 2013. Australian dentists who have installed compliant amalgam separators are likely to be ahead of
A pristine environment is something we all aim for, but how do you balance that with infection control guidelines?
29
30 the curve when the UNEP makes a ruling in this area. The waste management issue of what to do with amalgam is only one aspect of a complex problem. “I thought the amalgam separator was a great idea and was an early adopter of the system,” says Dr Adeline Chong. “Everything in dentistry is expensive, relatively speaking,” she says. “The amalgam separator was not one of our most expen-sive purchases, and has been worth the outlay.” But Dr Chong says that other aspects of green dentistry can be challenging when they come into conflict with patient health outcomes.
“We’d love to recycle and re-use everything—especially our plastics—but infection control is of paramount importance and we just can’t risk contamination of our surgery and our patients’ health,” says Dr Chong. “If there’s any risk of contamination, we throw it away.”
aste management and the need to re-use and recycle are two areas that come into conflict when so many of the materials used in dental practice constitute a biohaz-ard risk. While some surgery items can be re-used—Dr
Chong says that the Australia Dental practice has reduced waste by opting to sterilise and re-use micro fibre towels in its sterilisation room, rather than paper towelling—the safety of patients will always trump environmental concerns when it comes to re-use.
“Recycling in dentistry is the next big issue to be tackled. It is difficult because bio-degradable plastic requires a different set of processing requirements—it cannot just go into landfill,” says Garry Pearson of ADAVB. The need for stringent infection control measures also comes into play: “Public health outcomes are the first priority, then the health of dentists and their staff. Against these considerations, environmental concerns must come third.”
Australian Dental Industry Association (ADIA) CEO Troy Williams says that energy inputs into sterilisation of reusable dental products
make their use less sustainable than well-produced biodegradable disposables—for example, wax-coated paper cups. He also notes that bio-hazardous material does not enter the waste stream or landfill, so their path into the environment cannot be measured in the same way as comparable products in other industries.
Williams says that there are only small efficiencies to be gained from energy saving on dental equipment itself, which is not a big user of electricity, and he sees the amalgam issue as a waste man-agement issue which is more or less under control.
“The global indications are that amalgam will cease to be a restorative agent within 25 years—therefore it is a waste manage-ment issue rather than an ongoing sustainability issue,” says Williams. These days, amalgam tends to enter the environment through extraction of existing fillings rather than new placements.
Williams believes that planning for economies of scale represents the greatest opportunity for waste and energy reduction: “In terms of the broader supply chain issues related to minimising resource use, probably the greatest area for reform is in the purchasing patterns of dental practices. Some practices tend to order their products in a piecemeal fashion, which increases packaging and transport costs. There are very few dental practices that will look at their resource needs over anything more than a month. If they looked at their purchasing patterns over the longer term it would allow them to exercise a bit of management to reduce their costs in freight, but also in packaging.”
Of course, an added benefit of waste reduction is cost reduc-tions. “Our expenses are less than we would expect to pay if we were running a non-green practice,” says Amy Leicht.
YOUR bUSINESS
From left to right: Dental assistants Sharon Williams, Andrea Byrne and practice manager Anita Roe from Australia Dental.
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NEWS & EVENTS COVER STORY YOuR buSiNESS YOuR LiFEYOuR TOOLS
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Tools of the tradeAn electrical treatment for dry mouth, a very hi-res camera, the best matrix system and more are in the spotlight
Hawe Supermat matrixby Dr Mark Foster, Castlegate Family Dental Care, Woodvale, WA
I treat a lot of children and adults for restorative dentistry that is performed under a general anaesthetic. I use a rubber dam and magnification for every case and the Hawe Supermat matrix works extremely well in these situations.
What’s good about itWhen restoring interproximal lesions using a standard Siqveland or Tofflemire matrix system, the arm of the matrix band can obscure your field of vision. This problem is non-existent with the Supermat matrix.
This matrix system consists of a placement tool onto which the spool and band of your choice is placed. They tend to stay in place better when there is a short crown height as this eliminates the need to hold the band while the cavity is restored.
The metal or celluloid bands come in various sizes and are very easy to place. When restoring multiple teeth in one quadrant, multiple bands can be placed with no interference to access or vision.
What’s not so goodYou really need to have a rubber dam in situ when using this system as there is no metal arm to help retract the cheek. The small pre-formed rings are quite expensive but you can buy the plastic spools separately and make them yourself. That is a cheaper option and allows you to choose your preferred band.
Where did you get itHenry Schein Halas.
Nikon D90 cameraby Dr Robert Harper, Richmond Fine Dentistry, VIC
I have a Nikon D300 for personal use and a D90 for my clinical work in the surgery. The D90 is a little simpler but it works just as well. I’ve teamed it up with the Nikon 105mm Micronikkor lens with a maximum f-stop of 2.8. It’s a pretty fast lens and the images are clear and sharp.
What’s good about itI take a series of photos during new patient examinations and they’re great for aesthetic assessment. There’s also a ‘wow’ effect when patients see their teeth at 50 times normal size. You don’t have to say anything; they diagnose the problems themselves. The D90 has a very high resolution of 14 megapixels. This is why I prefer a modern digital camera to an intra-oral camera. The 14-megapixel resolution is orders of magnitude higher than what is available on any intra-oral. The flash is a Nikon Speedlight SB-R200 which is battery driven and radio controlled. I use Adobe Lightroom V.4 software to manipulate the images. Once a line is drawn from one pupil to the other, you can relate the incisal edge of the teeth to the line of the eyes. They’re meant to be parallel but, of course, they are often not. This image can be used as part of your planning and diagnosis.
What’s not so goodYou need to use cheek retractors and mirrors so it takes a little more time to set up. There’s also a bit of a learning curve but once the camera settings are right, a good quality image is produced each time.
Where did you get itDigital Camera Warehouse, Northcote, VIC.
NEWS & EVENTS COVER STORY YOuR buSiNESS YOuR LiFEYOuR TOOLS
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Tools of the trade (continued from page 33)
Salliwell GenNarinoby Dr Harry Marget, East Bentleigh Dental Group, East Bentleigh, VIC
The GenNarino is a device for the treatment of xerostomia or dry mouth. It uses electrical pulses to directly stimulate the nerves associated with salivary gland secretions. An impression is taken of the patient’s lower jaw and the device is positioned in a tailor-made mouthguard. I’ve had very good results with it.
What’s good about itIt’s not very expensive to manufacture the device, success is guaranteed and it offers a way forward for suffering patients.
The device is worn as needed—whenever the patient feels oral dryness. A remote control turns it on and the mouthpiece only needs to be in position for between one and five minutes at a time. Between two and five times a day is usually enough.
Patients can’t feel the electrical pulses and there are no side effects. This makes it a far superior method of treatment compared to drugs that often have adverse side effects.
The GenNarino is an easy and cost-effective way to treat dry mouth and all the associated problems.
What’s not so goodThe only minor drawback is that the device lasts for one year and then a new mouthpiece needs to be fabricated with fresh batteries. It’s also important to remind the patient not to sleep with it in position.
Where did you get itGolden Medical; goldenmedical.com.au.
Seiler Revelation operating microscopeby Dr Andrew Ziepe, Duncraig Village Dental, Duncraig, WA
I’ve been using this microscope for the past seven years. The reason I purchased it originally was that it makes you sit up straight and forces you to maintain good posture. If you suffer from a bad back or neck, it’s an excellent option. I’ve had much less back pain since I started using it.
What’s good about itThe magnification factor is far greater than what is possible with any loupes. It’s adjustable so it can have low magnification and a big field of view or—when looking at endodontics—the magnification can be cranked way up. The field of view decreases but that’s not a problem as long as it’s centred properly. I believe it’s almost impossible to do endodontics well without a microscope.
I also use it for general restorative work and examinations. It’s great for extractions when there is a broken root. I use a fine sucker tip, irrigate the area and the microscope allows me to see exactly what’s happening. Often I can use an elevator to just elevate around the root.
I have it connected to a monitor so my nurse can see what I’m seeing. For examinations I also let the patient watch the monitor.
What’s not so goodI find it difficult to do crown preps with a microscope, especially in the lower jaw. You need to look from one side, then the other side and then hold and rotate the mirror buccal palatal. I still use loupes quite frequently. I think it would be unwise to have a microscope and not have loupes.
Where did you get itDental Medical Technologies.
NEWS & EVENTS COVER STORY YOuR buSiNESS YOuR LiFEpROduCT guidE
Website and email product guide
Bite magazine’s guide to the best website and email products for dentists on the
market today.
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NEWS & EVENTS COVER STORY YOuR buSiNESS YOuR LiFE
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Website and email product guide
Online Appointment Booking In our modern day, web-connected world, more and more people are opting for the convenience of scheduling appointments online.
While the phone might be the most tradi-tional and standard method of contacting
patients to schedule an appointment, Online Booking provides a more convenient, efficient and successful method of scheduling and confirming patient bookings.
Software of Excellence’s Online Booking portal makes the process simple for both patients and the dental practice.
Case Study: Studental UK“I don’t know how we managed without it”
Originally set up to service Uni-versity students and staff, Studental UK opened their doors to the general public and now have several thou-sand registered patients.
The Studental team has long em-braced technological developments in terms of patient communication and has used SMS messaging and emails for both recalls and appointment reminders for a number of years.
While these methods resulted in a high percentage of successful recalls and low failed to attend (FTA) rates, they also had an unintended effect. Recalls sent by SMS and email were responded to immediately by patients phoning the practice to make appointments, thereby making the receptionists and the phone lines extremely busy.
Reception Manager, Deb Morris commented: “We send out hundreds of recalls every month and after sending the recalls, our phone lines would always become extremely busy. This meant the days following a recall send out were always highly stressful as patients were getting frustrated when they were unable to get through to the practice, either to book in their recall or to make a
general enquiry.”This situation was the main motiva-
tor for the practice to adopt Software of Excellence’s Online Appointment Booking module.
This module integrates online ap-pointment booking with the practice’s existing recall procedures as an email or SMS recall can be sent straight out of OASiS and EXACT with a link to the booking portal. The software is indi-vidually configured by the practice to include certain defined criteria – a process that Deb found very straightforward.
“After Software of Excellence had remotely installed the software, I simply logged into the web portal and input the relevant practice data such as dentists, opening hours, directions to the practice etc – it was very quick and easy.”
The patients at Studental have fully embraced the new technology and appreciate the fact that they can make appointments at a time that is convenient for them instead of be-
ing constrained by practice opening hours. There have been no increase in FTAs as a result of the new online approach, which is evidence that the booking process and susequent confirmation back to patients is working effectively.
Studental has also been one of the first practices to utilise online appointment booking for new patients via their website.
“Enabling new patients to register for appointments via our website is just a natural extension of the online provision we already offer.The intro-duction of online booking has sig-nalled a radical step forward for our practice; by reducing this previously labour-intensive task our reception team is able to dedicate more time dealing with face to face patient que-ries without additional pressure – as a result we have more satisfied patients and a more efficient practice.
“The whole process works seam-lessly and I can’t believe how we ever existed without it.”
Choose which appointments you want to make available and allow patients to book their appointment directly from your website. Once booked, the patient will receive an email conf irming their booking and your practice appointment book will automatically update with the new appointment!
Plus if you don’t already have a website, then Software of Excellence can also help to create a customised web form for your practice.
Created for practices using EXACT or OASiS practice management software. Online Bookings enables patients to go online and book their own appointments, with live data identifying available times.
Make booking appointments a breeze for your patients. Now with Online Bookings you can allow patients to book their own appointment on your website. Anytime, anywhere.
FIND OUT MORE: WEB: www.softwareofexcellence.com EMAIL: [email protected] AUST TEL: 1300 889 668 NZ TEL: 0800 930 171
Choose which appointments you want to make available and allow patients to book their appointment directly from your website. Once booked, the patient will receive an email conf irming their booking and your practice appointment book will automatically update with the new appointment!
Plus if you don’t already have a website, then Software of Excellence can also help to create a customised web form for your practice.
Created for practices using EXACT or OASiS practice management software. Online Bookings enables patients to go online and book their own appointments, with live data identifying available times.
Make booking appointments a breeze for your patients. Now with Online Bookings you can allow patients to book their own appointment on your website. Anytime, anywhere.
FIND OUT MORE: WEB: www.softwareofexcellence.com EMAIL: [email protected] AUST TEL: 1300 889 668 NZ TEL: 0800 930 171
AU-NZ / ONLINE BOOKINGS / REV1 / NOV 2012
NEWS & EVENTS COVER STORY YOuR buSiNESS YOuR LiFE
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Website and email product guide
10 Steps to Maximise Your Website’s Effectiveness The Essential Guide to Driving Internet Traffic & Getting New Clients
e all know how important a website is to a business’s marketing strategy. Having a website alone isn’t the key to great results. Your website needs to not just exist, it needs to
perform. It needs to attract visitors, educate them and convince them to make a booking. This article lays out the steps to maximising your internet presence.
Step 1: Get found online A great website isn’t so great if no one visits it. How you are going to get visitors to your website? Are you going to put your time and money into Search Engine Optimization (SEO / organic search), Pay Per Click advertising (Google Adwords) or both?
Step 2: Think about your first impression Your next focus is getting people to stay on your website. Your website should instantly and easily represent who you are and what you offer. Remember, you never get a second chance to make a first impression.
Step 3: Use the right images Images can be a powerful element to any website but you need to use them wisely. Photos of real people out-perform stock photos by 95% in client conversion. Invest in getting professional images for your website.
Step 4: Make your website easy to navigateKeep visitors on your website with good navigation. If people can’t find what they are looking for, they will give up and leave. Make sure your navigation is simple and logical. Make it easy for people to find what they are looking for.
Step 5: Make your website accessibleWith growth in mobile phones and tablet devices, people are surfing the internet more than ever before. Make sure that anyone visiting your website can view it no matter what device they are using.
Step 6: Create great content Content is critical to a website. It is what search engines and people are looking for. It’s what drives visitors to your site and
turns visitors into clients. It should be readily apparent what your website is about, what they can do there and why visitors should take action.
Step 7: Maintain a blog Blogging is a critical part of an internet marketing strategy. Your blog should be a section of your business website (not on a separate site).
A blog creates fresh content and more pages of content, which is great for SEO. It helps establish you as an industry expert and is a great channel to engage with your customers. A blog also helps drive more traffic and leads back to your website.
Step 8: Make content shareable & social Social media websites are experiencing exponential growth. Make it easy for people to share and talk about your business and therefore increase traffic to your website.
Step 9: Convert website visitors to clientsYour website should include clear call-to-actions (CTA’s) and next steps. CTAs are the key to lead generation and make it easy to drive a visitor to take a desired action or next step.
Step 10: Contact wellsites today & maximise your internet presence Internet usage is growing rapidly and you need to be there when potential clients come looking. If you are not seriously thinking about your internet marketing strategy your competition will be.
Wellsites are the experts in getting your dental online marketing working effectively. We understand the How’s and the Whys of getting the most out of your internet marketing.
We believe in a long term relationship with our clients and will support your business on an ongoing basis, ensuring that you are aware of the latest online trends and what they mean to you.
Who has the time to blog?A blog can keep you in front of existing patients, get you in front of new patients, and lift you up the Google rankings—all while doing it in a way that’s unique to you
Have you blogged recently?Many medical professionals have blogs as part of their websites—but when was the last time you posted something?
Blogs are a great way to connect with your patients, and to help new patients find you. It also does wonders for your Google results. But if you aren’t posting something engaging and interesting to your blog at least once a month, you won’t be getting all the benefits a blog can bring your business.
But who has the time to do it?Nobody. It’s not just that you’re seeing patients all day—by the end of the day, you’re tired and not in the frame of mind necessary to punch out a snappy piece of writing.
That’s where we come in. Our team of journalists and editors can write, edit and prepare your blog for you. Our basic package includes 12 months of blog posts, written and edited by us and all approved by you. All you have to do is upload it to your blog every month.
Do blogs work out better than advertising?In a word, yes.
Traditional advertising in local news-papers and the Yellow Pages just don’t work as well anymore. Because there’s so much advertising around these days, people tend to tune out from it, and notice it less.
But blogs aren’t advertising—they engage your patients. A blog can forewarn patients during busy times, or when you’re out of town. When it’s done well, and updated regularly, a blog can do three things for you:• Give an existing patient a reason to
return regularly to your website, to see what you’re thinking, or saying;
• Give a new patient a reason to visit you, because they not only get an
idea from your blog about what you do—but also who you are, what you’re thinking, and what you’re interesting in.
• Improve your search ranking on Google because the way Google ranks sites now, it rewards those websites that are updated regularly with valuable content.Most importantly, a blog is unique to
you—it’s written in YOUR voice, show-casing YOUR concerns and interests. It’s not a basic ad template knocked to-gether in a design house with a picture of an apple and a tooth.
Why use Engage Custom Content for your blog? Because as publish-ers of Bite magazine, we understand dentistry, and we’re committed to the profession. Call Mark Brown on (02) 9660 6995 or email him at [email protected] today to find out how a blog can help your business.
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As a special offer for readers of Bite, call in December and mention this page when you ring us. We’ll give you a $500 discount off our regular fees.
For $1500* and 25 minutes of your time, we can give you a year’s worth of UNIQUE-TO-YOU, Google-friendly content for your practice’s blog!
You don’t have time to write a new blog post every month.Let us do it for you. The content we create will be: unique to you and your practice (no other website in the world will ever have it) a huge boost to your search engine results (Google rewards websites with regularly updated, engaging content by putting them higher in search results) a great way of engaging patients when they’re not in the chair
Best of all, mention this ad when you call and receive a $500 discount off our usual fee*!
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Call Engage Custom Content today to take advantage of this one-off offer…
MacPractice, Web Integration and solutions for Dentists on the run.
MacPractice is not just software.MacPractice is a client-centriccompany with a passion forsupplying and supporting worldclasssolutions for doctors and theirpractices.”Mark Hollis. CEO, MacPractice, Inc.
Created out of experience that started with Dental-Mac in 1984, MacPractice now provides solutions
for well over 4000 practices world wide. Since the beginning in 1984, the developers of MacPractice have listened to clients and responded by creating applications that leverage the powerful features of each new version of Apple’s operating systems and developer environments.
Increasingly the features ineach new version from Apple use the internet and are in the ‘cloud’.
MacPractice practitioners are able to utilise the sensational features of Retina display iPads and iPhones in and out of their clinics. With the ability to access patient data securely and easily with the MacPractice interface for the iPad, appointments, reports and referral information can be viewed from anywhere with internet.
A hospital rounds assistant and more, the MacPractice interface to the iPad & iPhone makes all these functions seamless; Viewing patient appointments, contact information, post charges, review Rx history, tap to email a patient, tap to call a patient and create new patients among other tasks. The practitioner can also view and filter daily reports, referring doctors and create and view orders for staff to implement.
Using Apple laptops, practitioners have the full power of MacPractice at their disposal, across the internet to the clinic.
In reception and administration
MacPractice works seamlessly with providers of sms, voice and email reminder services (such as Autore-mind) to keep the practice patients up to date with their appointments.
Patients appreciate the ability to reply to an SMS reminder and staff appreciate that the interaction results in an automatic schedule update.
On the clinic’s web site, patients can request appointments through the MacPractice Web Portal which is tightly integrated with the clinic’s web site.
Dentmed, the Australian represen-tative of MacPractice, have found that passion for supplying and supporting worldclass solutions for doctors and their practices.
The associated support philosophy followed by MacPractice, combined with dedication to the Applesque “Just works” mantra, has produced the most seamless Practice suite integration seen in the industry.
Dentmed are consistently delighted to be able to assist Practitioners implement these technologies into their practices and are thrilled to see the savings in time and effort a MacPractice solution brings, from single practitioner practices through to complex 50+ chair clinics.
As we move into the future of dental practice, seeing even more pervasive integration of our digital lives it’s good to know that the leading Apple dental software devel-oper, MacPractice, has their eye on the ball to ensure that it continues to “just work” for our practices.
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Dr Wohrle using the Nobel Biocare Clinician implant system, another superbly
integrated MacOSX dental application, which he uses in
conjunction with MacPractice.
Dr. Mark Santana, DDS(wandering a clinic with his MacBook Pro): “Since implementingMacPractice in October of 2009,words cannot describe thesuccess of this business decision.The lifetime value of this upgradeto MacPractice is an absolutehome run.”
P r a c t i c e w i t h M a c s ?
N o t J u s t S o f t w a r e28 years of solutions to Practitioners whose Practices...
J u s t W o r k
Provisioning dental & medical practices with operational strategies, business and IT systems.
Proudly the Australian representative of MacPractice, delivering better practice outcomes to more than 4000 practices worldwide.Phone: 1300 398 334 www.dentmed.com.au
www.macpractice.com
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Distance a barrier no moreDr Leon Loftus has a business model that would not be possible without dental4windows.
Whilst owning a practice in central Victoria in 2008, Dr Loftus and his wife purchased two
practices in Northern NSW, believing their existing PMS would operate effi-ciently over any distance using Termi-nal Services. Very quickly it became apparent he had been misled, unable to access the practices remotely through Terminal Services. This made managing them remotely much harder and for Dr Loftus, unacceptable.
At the time, dental4windows were publicising their upcoming digital imaging module, Mediasuite. Dr Loftus purchased dental4windows.
Dr Loftus says, “Centaur Software arranged to do a data transfer from our existing practice management system
to the newly installed dental4windows with most details including all patient demographics coming across.
I am extremely particular about ef-ficiencies within the practices and am extremely happy with the efficiencies dental4windows delivers, from the ap-pointment book operation through to the SMS functionality, Treatment Notes and even Bank Reconciliations. The reports are excellent and extremely accurate as apposed to what was found when using the opposition product.
I run a team of dentists and in most cases, they already knew the system or found it very easy to pick up, and with its reporting easily operated via Terminal Services, I have the confidence we are always running to plan and in control.
I am very focussed on business
success, but this system is just as much about patient care as it is about efficiencies and management. We have invested heavily in digital x-ray technol-ogy and plan to continue our expansion. Dental4windows provides management tools and capability beyond anything else I have seen or even heard of.
For me, patient care is the most important aspect to the business and I am continually aiming to deliver the best patient care possible with a focus also on understanding the importance of our individual community contribution.
For any practice considering what practice management system to pur-chase, my advice is that dental4windows has the capacity to better manage and expand the practice but is clearly the eas-iest to use for those just starting out.” 44
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YOUR LIFENEWS & EVENTS COVER STORY YOUR BUSINESS YOUR TOOLS
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On the trackDespite pouring rain, painful blisters and mud, Dr Tim Topalov of River Dental in Gympie, Qld, was determined to finish the Kokoda Challenge
The Kokoda Challenge is a 96-kilometre endurance event that must be completed in under 39 hours. It takes place on the Gold Coast hinterland and the 2012 event was the wettest challenge in its history. The toughest part was the five-kilometre climb up to
Duncan Park. It’s a very steep hill that was wet and slippery with mud. For every two steps forward, you slipped half a step back. We had to tackle it at three o’clock in the morning, having already covered 70 kilometres. People around me were really struggling and there were plenty of tears. It took about an hour and a half to get to the top and then it was just as steep on the descent. That was a real killer on the knees and toes.
“It was Tania, our receptionist, who got me involved. She likes to run and mentioned there was a 30-kilometre Kokoda Challenge in Brisbane. I found myself teamed up with Tania, her friend and my son’s girlfriend.
“Once we finished the 30-kilometre challenge, we had no intention of doing the 96-kilometre event. We all agreed it was a stupid idea and we shouldn’t do it. Our attitude gradually changed as the entry date approached. With some apprehension, we decided to give it a go. At first the muddy paths were a bit of fun but they soon became nothing but hard work. It’s a non-stop event but none of us ever considered giving up. We had done a fair bit of training and were mentally strong. The only way we would toss it in was if we were physically injured. We completed the 96 kilometres in just over 30 hours.
“Waking up the day after I finished, I felt like I’d won a grand final. I was on cloud nine for a week. If there was a team that needed another member, I could probably be talked into doing it all again—but don’t tell anyone!
All finance products are issued by Investec Bank (Australia) Limited ABN 55 071 292 594, AFSL 234975, Australian Credit Licence No. 234975 (Investec Bank). All finance is subject to our credit assessment criteria. Terms and conditions, fees and charges apply. Information contained in this document is general in nature and does not take into account your personal financial or investment needs or circumstances. We reserve the right to cease offering these products at any time without notice. You should obtain independent financial, tax and legal advice, as appropriate.Qantas Frequent Flyer points are earned in accordance with the Investec/Qantas Terms and Conditions available at www.investec.com.au/card. Points are earned on eligible purchases only. You must be a member of the Qantas Frequent Flyer program in order to earn and redeem points. Qantas Frequent Flyer points and membership are subject to the Qantas Frequent Flyer program Terms and Conditions. Full details are available at www.qantas.com/frequentflyer. Investec Bank recommends that you seek independent tax advice in respect of the tax consequences (including fringe benefits tax, and goods and services tax and income tax) arising from the use of this product or from participating in the Qantas Frequent Flyer program or from using any of the rewards or other available program facilities. Insurance products are offered by Experien Insurance Services, the preferred supplier of insurance products to Investec Bank.
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O u t o f t h e O r d i n a r y™
There is a profusion of credit cards on the market, but not a lot to distinguish one from another. Until now.
Investec has come up with a card specially designed for the dental profession. It’s quite clever: for instance, you can buy a car or equipment, earn Qantas Frequent Flyer points and then roll it over into a lease! You can also pay off your new and existing equipment or fit-out contracts with your card to earn even more points. Then there is the complimentary travel insurance, airport lounge access and concierge service... At long last, a credit card that gives more than it takes.
Take a look at investec.com.au/medical or call one of our financial specialists on 1300 131 141 to find out how we can help.
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YOUR LIFE
All finance products are issued by Investec Bank (Australia) Limited ABN 55 071 292 594, AFSL 234975, Australian Credit Licence No. 234975 (Investec Bank). All finance is subject to our credit assessment criteria. Terms and conditions, fees and charges apply. Information contained in this document is general in nature and does not take into account your personal financial or investment needs or circumstances. We reserve the right to cease offering these products at any time without notice. You should obtain independent financial, tax and legal advice, as appropriate.Qantas Frequent Flyer points are earned in accordance with the Investec/Qantas Terms and Conditions available at www.investec.com.au/card. Points are earned on eligible purchases only. You must be a member of the Qantas Frequent Flyer program in order to earn and redeem points. Qantas Frequent Flyer points and membership are subject to the Qantas Frequent Flyer program Terms and Conditions. Full details are available at www.qantas.com/frequentflyer. Investec Bank recommends that you seek independent tax advice in respect of the tax consequences (including fringe benefits tax, and goods and services tax and income tax) arising from the use of this product or from participating in the Qantas Frequent Flyer program or from using any of the rewards or other available program facilities. Insurance products are offered by Experien Insurance Services, the preferred supplier of insurance products to Investec Bank.
Home loans | Car finance | Transactional banking and overdrafts | Savings and deposits | Credit cards | Foreign exchange | Goodwill and practice purchase loans Commercial and industrial property finance | Equipment and fit-out finance | SMSF lending and deposits | Income protection and life insurance
O u t o f t h e O r d i n a r y™
There is a profusion of credit cards on the market, but not a lot to distinguish one from another. Until now.
Investec has come up with a card specially designed for the dental profession. It’s quite clever: for instance, you can buy a car or equipment, earn Qantas Frequent Flyer points and then roll it over into a lease! You can also pay off your new and existing equipment or fit-out contracts with your card to earn even more points. Then there is the complimentary travel insurance, airport lounge access and concierge service... At long last, a credit card that gives more than it takes.
Take a look at investec.com.au/medical or call one of our financial specialists on 1300 131 141 to find out how we can help.
The smoothest operation you’ll ever performBuy a car or equipment with your card and take a holiday on us
Discover the ‘Professional education’ section on
www.colgateprofessional.com.au
this provides you with resources to help improve oral health and wellbeing for your patients.
Further your development with Free continuing professional eDucation programs
Courses inClude:• General dentistry• Practice management • Periodontics
